Early detection and treatment of malnutrition in Togo saves lives

Measurement of the brachial perimeter is a mean of detecting malnutrition, both severe and moderate. Severe malnutrition affects 14 per cent children under five in Togo.

By Hadrien Bonnaud

BOUGOU, Togo, 2 June 2008 – Hundreds of mothers wait in the early morning at a school in Bogou, holding their children and hoping to hear good news about their prospects.

This small village is the first stop on a multi-region campaign to identify and register undernourished children. According to UNICEF Togo, malnutrition rates exceed 10 per cent in three of the country’s five regions, designating the situation in Maritime, Kara, and Savanes districts a nutritional emergency. Some 50,000 children living in these areas are among the acutely malnourished.

One of the 45 health agents trained by UNICEF and drafted to measure the children’s height, weight, age and forearm diameter is pleased with the turnout. “The mobilization surpasses all of our hopes,” he says.

By the end of the day, more than 1,000 children will be seen and assessed at the Bogou school. Overall, the campaign aims to reach more than 130 remote communities and train more than 100 community health workers. In the past 10 months, UNICEF has helped open 77 nutrition rehabilitation centres in Togo.

Two-year-old Kofi suffers from severe malnutrition. An early detection and treatment campaign launched by UNICEF in Togo assures that he will receive appropriate medical care.

Community-based nutrition managementMalnutrition is treated according to its classification as moderate or severe. If a child is diagnosed as moderately malnourished, a bag of flour enriched with vitamins and protein is recommended, and the mother is urged to return to the health centre for a follow-up.

But in cases of severe malnutrition, a more intensive therapy is required. For the past decade, UNICEF has advocated a community-based management of even severe malnutrition. Home-based therapy has become a reality thanks to the developments of ready-to-use food (RUTF), which can be administered by caregivers and does not require water for mixing.

In Togo, children diagnosed as severely malnourished are given a paste enriched with vitamin and a peanut-based protein called Plumpy’nut. The mother is provided with as much therapeutic food as necessary for her child’s recovery.

‘Kofi will soon recover’One of the children reached by Togo’s current nutrition campaign, Kofi, is two years old and weighs only 7.5 kg for a height of 75 cm. He suffers from acute severe malnutrition, which, if not treated in time, could result in death.

The health agent asks Kofi’s mother, Yamba, to feed him with Plumpy’nut.

“I didn’t know anything about malnutrition before coming here. I came because my son has a fever and refuses to eat,” says Yamba. “But the doctor told me that Kofi will soon recover if I follow the treatment carefully. This paste, Plumpy’nut, is like magic!”

High costs, continued commitmentToday, more than ever, the spectre of looming malnutrition is of great concern. But the very food crisis that threatens the most vulnerable to food instability also means increased RUTF production costs. More than half the cost of Plumpy’nut, for example, comes from the price of powdered milk – an ingredient that has risen sharply in cost over the past 18 months.

“For now, we as UNICEF are protected from the rising cost of production because of the fact that we buy in large bulk,” said Senior Advisor on Nutrition Flora Sibanda-Mulder. “In fact, we are the biggest procurer of RUTF.”

Last year, UNICEF spent $18 million on RUTF for free distribution in about 40 countries. As rising food prices and insecurity become more prevalent, the agency will continue to honour its mandate to treat and prevent severe acute malnutrition wherever it is found.